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Flu Shot

David Watts, Nonfiction

She stands in my examining room unable to sit, pacing, then stopping tensely, as if paralyzed by the urge to pace. Three times she has made this appointment, three times a no-show. My secretary raised her eyebrow when she came in. But I have nothing to say.

Now her eyes touch and glide, touch and glide over me like the scan of an electron microscope, programmed for the penetrating search.

I fetch the vaccine, rend the silver packet for its sterile pledget, swab the red nipple of the rubber disc at the top, then plunge and withdraw just the right 0.5 cc. amount. I have anticipated this visit.

I ask if she's ready. She says yes. And now the killed virus I inject into the dense fibrils of her shoulder will evoke from the rangy lymphocytes their molecules of protection. She winces, turns to go, then turns back.

Why did he have to die? And as she says this, her body gives a little seizure-like lurch. Couldn't you have prevented it?

I gather the detritus I've left behind: the silver crimps of packet walls torn open, the needle guard, the soiled pledget with its spot of blood in the center, the dangerous needle I will place in the red plastic carton marked hazardous. I remember his last office exam: 62 years old, healthy. A few small problems with his cholesterol medications that we focused on. As a part of his general check-up I might have ordered a screening sigmoidoscopy. I did not. In my ear I can hear the admonitions of hospital lawyers cautioning me not to say too much. Don't commit yourself, they might say. And I feel—what is it?—something like the shame of being caught doing something wrong. But in the cavity of that humiliation, finally exposed, I feel no desire to waffle or dodge. She deserves better than that.

Yes, I say. The cancer might have been prevented. And then there is just she and I and the truth in the room.

Strange, she says. All those years with you and with the doctor before you, nobody ever recommended a sigmoidoscopy. If that had been done the year before, would you have caught the cancer in time?

The detritus has been removed. The needle is in its safe place. I have no urge to fidget in the face of her question.

It's possible, I say, if it were still a polyp. Or if it hadn't spread too far. And I realize that though this was true, it is a manner of deflection. I am drawn to return to the unadorned answer. It's possible, I say. It's possible it could have been prevented.

She is silent.

I am silent.

She waits. I have no one. No children, no family. He was all I had.

I nod.

She reaches for her overcoat.

You'll probably have to do something about this or let it go, I say. All this hurt will come to no good.

I would never do anything, she says. I like you. I think you are a good doctor. I want—I think I want—to continue to come and see you, but it will be hard.

I'm sorry, I say. And I want you to know that I believe you should do what you need to do even if it means...

No, no. Well, maybe. I don't know.

She leaves. And returns for her flu shot the following year, and the year after, never mentioning her husband, and then, eventually, for her own screening sigmoidoscopy, well in advance of its time, a request I honor like an obedient pharmacist filling the unusual prescription, knowing it is too early, but conscious of the fear she is facing, conscious of the forgiveness she brings, coming to me for the help I might give, the test that might have saved her husband.